Chapter 30 Caring for the Child With a Integumentary Condition

Chapter 30  Caring for the Child With a Integumentary Condition

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. A mother–baby nurse is demonstrating swaddling a neonate as a method of keeping the baby warm. The mother asks why she needs to be so careful about the baby’s temperature. Which response by the nurse is the most appropriate?
A.
“After being in your womb for 9 months, this is how the baby prefers to stay.”
B.
“Babies’ immune systems are immature; any cold breeze will make them sick.”
C.
“Their skin is thin and they have little fat, so it’s hard to control their temperature.”
D.
“You need to keep their temperature above what we call normal to keep them well.”

ANS: C
Babies have thin skin, a large body surface area, scanty subcutaneous fat, and immature neurological systems. All these factors combined make it difficult for a baby to regulate his or her temperature. The other statements are not factual or informative.

Cognitive Level: Comprehension/Understanding
Content Area: Pediatrics/Maternity
Patient Needs: Health Promotion and Maintenance
Integrated Process: Teaching/Learning
Difficulty: Easy

PTS: 1

2. A nurse is working with a child who has a chronic skin disorder consisting of many vesicles and pustules. Which nursing assessment indicates that a priority long-term goal has been met?
A.
Child states that he no longer gets teased at school because of his appearance.
B.
Parents and child verbalize acceptance of disease process and need for medication.
C.
Patient participates in sporting events and other after school-activities regularly.
D.
Skin around primary lesions remains free of redness, warmth, swelling, and pain.

ANS: D
All options show evidence of positive outcomes. However, physical needs take priority over psychosocial needs, so absence of infection is evidence that a priority goal has been met. Secondary infection can occur due to scratching, picking, and the presence of the lesions themselves.

Cognitive Level: Evaluation/Evaluating
Content Area: Pediatrics/Maternity
Patient Needs: Physiological Integrity: Reduction of Risk Potential
Integrated Process: Nursing Process: Evaluation
Difficulty: Moderate

PTS: 1

3. A child takes anti-inflammatory medications for a chronic condition. The mother asks the nurse why the child’s cuts and scrapes seem to take so long to heal. Which response by the nurse is the most appropriate?
A.
“Chronic diseases always affect the healing process.”
B.
“Inflammation is the first stage of healing wounds.”
C.
“Sick kids tend to be anemic, which often delays healing.”
D.
“Wound healing would not be affected in your child.”

ANS: B
The first stage of healing consists of the inflammatory process, which is being hampered by this child’s need to take chronic anti-inflammatory medications. Although chronic disease can affect healing, this answer is too vague to be useful. Not all sick children are anemic. Wound healing definitely would be affected in this child.

Cognitive Level: Comprehension/Understanding
Content Area: Pediatrics/Maternity
Patient Needs: Physiological Integrity: Physiological Adaptation
Integrated Process: Teaching/Learning
Difficulty: Moderate

PTS: 1

4. An adolescent patient has acne characterized by pustules and scarring. Which teaching information is most appropriate for the nurse to give the patient and family?
A.
“Scrub your face vigorously twice a day with soap and water.”
B.
“Tetracycline (Sumacin) will make you more sensitive to the sun.”
C.
“Use good moisturizer because treatment is very drying.”
D.
“You need a pregnancy test every 3 months on isotretinoin (Accutane).”

ANS: B
Tetracycline, minocyline, and doxycycline all cause photosensitivity, so the nurse should warn the teen about sun exposure and use of tanning beds. Skin cleansing should be gentle. Although acne treatments are very drying, makeup and moisturizers should not be applied on top of the dry skin. Pregnancy tests are done prior to starting treatment with Accutane, every month during treatment, and 1 month after treatment has stopped.

Cognitive Level: Application/Applying
Content Area: Pediatrics/Maternity
Patient Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Integrated Process: Teaching/Learning
Difficulty: Moderate

PTS: 1

5. A toddler has a few vesicular lesions on his hands that rupture, producing a honey-colored, sticky exudate. Based on this assessment, which medication does the nurse teach the parents about?
A.
Azithromycin (Zithromax)
B.
Amoxicillin/clavulanate (Augmentin)
C.
Doxycycline (Vibramycin)
D.
Mupirocin (Bactroban) ointment

ANS: D
This child has impetigo, which is treated in one of two ways. For limited lesions (which this child has), topical Bactroban is appropriate. For widespread lesions, Augmentin is one of the antibiotics used. Azithromycin and doxycycline are not used.

Cognitive Level: Application/Applying
Content Area: Pediatrics/Maternity
Patient Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Integrated Process: Nursing Process: Implementation
Difficulty: Moderate

PTS: 1